(videos coming soon)
Example #1: Infinity Walk
The Infinity Walk is an effective exercise to simultaneously activate the visual and vestibular systems and helps to increase activity between the right and left hemispheres of the brain.
Adding the addition of a cognitive exercise during the Infinity Walk will further increase brain activity.
We find this exercise helps to improve rotations (an action that often triggers freezing of gait and falls) and increases the automaticity of upper and lower body rotation/counter-rotation thus improving the body’s overall coordination and endurance. (John C. Murray, n.d.)
- Place 2 small objects a few feet apart (6-8 feet apart)
- Beginning in the middle of the 2 objects, have your client begin walking around the objects in a “figure 8” pattern outside then inside the objects.
- Once your client feels comfortable with this movement, add educational visual materials i.e. picture cards, phonic cards, spelling words, sight words, math facts, etc. To do this, start the client in the center of the chairs with his/her back to the object of attention (flashcards, tv, etc.). As your client walks the pattern, he/she should never lose sight of the target.
Keeping sight of the target causes the head to turn (activating the vestibular system) and eyes to track (activating the visual system).
I don’t have a name for this example, but here is how it works:
- Have your client sit on a stability ball (the provides a slightly unstable challenge by staying on the ball
- Next, looking straight ahead, have your client move their head in a figure 8 pattern. This will involve the turning of the head left to right and up and down, repeatedly.
- Add a layer by assigning a cognitive task.
Example #3: Walking with Head turns
This is a variation of exercise #11 in the Mini-BESTest:
- Have your client start walking (make sure the walk area is clear of debris)
- Cue your client to follow your lead. For example, when the trainer cues to turn left, the client turns the head left, etc.
- Have the client walk and turn their head from left to right, and repeat
- Progress by having the client walk while alternating looking up towards the ceiling and down to the floor
- Progress by having the client move the head in a figure 8 pattern while walking
- Add a cognitive challenge to any of these movements
Example #4: Hand-eye coordination and moving around your client
During a static or dynamic balance exercise, have the trainer/partner play catch with the client. This adds the element of hand-eye coordination. Progress by having the coach move around, throwing and catching the object from a different location each time. This will prompt the turning of the head and tracking of the eyes.
Crossing the Midline / Cross Body Movement Patterns
Movements requiring hands or feet to cross the midline of the body promote the coordination, communication, and integration of the left and right hemispheres of the brain. In childhood, cross body patterns are an integral component to brain development.
The midline is an imaginary line running down the center of the body and dividing it into left and right sides. Everyone can benefit from cross body movements, including the aging population and people with Parkinson’s.
Training sessions are greatly enhanced when including cross body movements and exercises. This also allows for more opportunities to implement stacking of other techniques discussed in this chapter.
Cross body examples
- Play a game of Twister
- Play catch with an emphasis on catching the ball off center
- Play softball, baseball, or whiffle ball (even if alone, place the ball on a tee or mount. Swinging the bat will cause the arms to cross the midline.
- Hit some golf balls
- The Cross Crawl – Sit or stand while you reach across the midline of your body with your left arm to touch your right knee and then repeat with right arm reaching to left knee. Exaggerating the arm reach is the better
- Pass a ball around your body
- Throw a ball at a target
- Try juggling
- Drumming (yes, you can cross the midline with a pair of sticks and a practice pad or pillow)
Now that you have an idea of what it means to cross the midline, try stacking additional challenges, i.e.:
- Add hand-eye coordination exercises when possible
- Add a cognitive challenge
- Activate vestibular and visual systems (i.e.: while the client is side-stepping, the trainer can add a cognitive exercise while continually moving around to different locations while play catch with a ball)
- Get creative! The sky is the limit